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drive improvement in adult social care

18 June 2018

The Care Quality Commission (CQC) has released nine case studies, explaining how services have developed from Inadequate ratings to Good. These examples are essential reading for any provider embarking on that journey and provide a valuable insight into the CQC’s priorities for all other providers.

Perhaps the key headline from the report relates to the recruitment and retention of capable, valued and supported staff. As ever the issue is not that staff do not care, it is the challenge of maintaining a suitable workforce in today’s care market.

That challenge is particularly high for providers of publicly-funded care. The CQC acknowledges the challenges faced in a time of rising staff costs and pressure on funding levels. The report also acts as a call to arms for commissioners to acknowledge the need to fund suitable staffing levels.

In reality obtaining that additional funding may be difficult. The recent Association of Directors of Adult Social Services (ADASS) report paints an overall picture of a sector struggling to meet need and maintain quality amid a fragile provider market, pressures from an NHS England in critical need of more funding and further planned social care budget costs.

Therefore providers will have to combine good practice in getting the best out of its staff, such as thorough recruitment checks, training and appraisal, with difficult decisions. For some that may involve reducing the number of residents cared for, as in at least one of the CQC’s case studies.

It is in part for this reason that leadership is identified as another report headline. Where services are struggling, a new perspective can often provide a fresh impetus. In most of the examples some addition to or change in management was required to achieve the improvements seen. The CQC highlights in the report the difference between management and leadership, emphasising the need to empower all staff members who take responsibility for the quality of their work and that of their teams.

It is this kind of cultural change that the CQC have also identified as essential to improvements in care quality. At the heart of this is encouraging staff members to speak out about things that are going wrong without fear of being ignored or blamed.

Providers that achieved improvements were also seen to have accepted the failings identified and to have used them as a 'roadmap to improvement', often starting with a fresh look at care planning to ensure person-centred care.

Other key areas for improvement identified in the report were closer working with partners, including commissioners and relatives, and building a community by enabling residents to get out into the community or involving local people in events at the service itself.

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